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Webinar tips► Questions: Submit any questions in the Q&A box► Technical issues: Email ON24 at [email protected]► After the webinar, you will receive a link to the recorded webinar with a copy of
the slides presented► Webinar audio will be played through your computer, no need to mute
your device
Presented by
Brian SperlingSenior Account Manager | GEHA
Mickey BasiAccount Manager | GEHA
Our Agenda
THE BASICS FEDVIP in retirement and FEHB rules about retirement1
2ENROLLMENT Medicare Parts A & B. Should I enroll in Part B? How and when should I enroll in Medicare?
3SUPPLEMENTAL PLANSMedigap or Medicare supplement plans Medicare Part C / Medicare Advantage Medicare Part D / Prescription coverage
4GEHA PLANS Exploring GEHA plans
OPM frequently asked questionsopm.gov/Retirement-Services/Retirement-FAQs
FEDVIPFederal Employees Dental and Vision Insurance Plan
5
No 5 year requirement.
2
Enrollment allowed in retirement.
$
Immediate annuity required.
FEHB regulations – 5 year ruleKnow the ground rules prior to retirement
5 years continuous coverage
Any FEHB plan within those 5 years
Includes coverage on spouse’s FEHB plan
Time covered under TRICARE or CHAMPUS included
Must be covered by FEHB at time of retirement
FEHB regulations Know the ground rules
CancelCannot re-enroll if canceled after
retirement
SuspendCan only suspend when enrolling in a
Medicare Advantage Plan or Tricare
Re-enrollmentAllowed during Open Season, involuntary termination by plan, move out of plan’s
service area
Post-retirement plan changesopm.gov/Retirement-Services
Only a click away: Health care needs change Change in family status
Post-retirement plan changesservicesonline.opm.gov
Post-retirement enrollment changes
Premiums deducted post-tax
Can reduce enrollment to Self Plus One or Self Only
Can cancel FEHB at any time
Know rules to re-enroll, very limited circumstances
Changes allowed for life events
Retirement is not a life event
Family coverage not required at retirement
Post-retirement enrollment changes
Enrolled in Self Plus One or Family plan upon death
Family member must be entitled to annuity as survivor
Monthly benefit after your death required
Survivorship benefits and lifetime coverage for survivor annuitants
Requirements:
How Medicare & FEHB work together
FEHB
The original Medicare
PREMIUMFREE*
PREMIUMMONTHLY
*Some individuals may not be eligible for premium-free Part A.
You should consider delaying enrollment in Part Bif you are still actively employed. Usually you
will not be penalized for late enrollment.
Medicare Part A
Inpatient hospital Skilled nursingfacility
Home health care Hospice care
Inpatient hospital out-of-pocket costs
Deductible Daily copay
$1,408 first 60 days $352 per day from 61-90 days$704 per day from 91-150 days
Most FEHB plans waive these costs when Medicare is primary
Medicare Part B – monthly premium
Outpatient therapies Ambulance Office visits Hospital visits
Medicare covers 80% after annual deductible of $198
Equipment and supplies Outpatient radiology Outpatient labs Outpatient facilities
File Individual Tax Return* File Joint Tax Return* Part B Monthly
Premium You Pay
$87,000 or less $174,000 or less $144.60
$87,001–$109,000 $174,001-$218,000 $202.40
$109,001–$136,000 $218,001-$272,000 $289.20
$136,001–$163,000 $272,001-$326,000 $376.00
$163,001-$500,000 $326,001-$750,000 $462.70
$500,001 and above $750,001 and above $491.60
91% of beneficiaries in 2019
*Amount based on modified adjusted gross income as reported on your IRS tax return from 2 years ago.
Part B premiums for 2020
$3
$144.60
$144.60 x 12
1966 2020
Part B premiums – monthly premium
Medicare enrollmentSocial Security enrolls, sends card. Centers for Medicare & Medicaid Services
(CMS) administers Medicare.
Three months before you turn 65
Automatic enrollment if already
receiving benefits
Medicare card mailed
Medicare enrollmentThere is a seven month window of eligibility for benefits
Your birthday month.
Three months before you turn 65.
Three months after you turn 65.
7 months
Medicare enrollmentApplying for benefits
General enrollment period January 1 – March 31
Coverage begins July 1Penalty may apply
Medicare enrollmentApplying for benefits
Still working? Apply for Medicare Part A
Premium freeYou’ve earned it
Reduce your out-of-pocket costs
Applying online is easyssa.gov/Medicare
Late enrollment penaltyPenalty is applied to the premium in 10% increments yearly
Can I enroll in Part B later?
Year onePremium x .10 = premium penalty
Year twoPremium x .20 = premium penalty
Year threePremium x .30 = premium penalty
Late enrollment exceptionTwo exceptions for those 65 and older
No penalty appliesIn most cases, where you are covered by your spouse’s employer group plan
No penalty appliesYou are coveredby FEHB as an
active employee
Late enrollment exceptionTwo exceptions for those 65 and older
Most people delay enrollment if
Health plan is the primary payer
Medicare is the secondary payer
Late enrollment exception Special enrollment period for those 65 and older
Period begins the month after you retire.
Eight month special enrollment period
Medicare supplement or Medigap plans
Pays Medicaredeductibles and
coinsurance
FEHB and Medicare will coordinate benefits to provide comprehensive coverage for federal employees. Federal employees
should not enroll in a Medicare supplement or Medigap plan.
Does not coverprescription drugs
Additionalmonthly premium
Medicare Part C – Medicare Advantage
Part A deductible Part B coinsurance
$1,408 20%
Most FEHB plans will not waive their copays and deductibles when an Advantage plan is primary
Must be enrolled in Part A & B Part C substitutes for Part A & B
Medicare Advantage – Regional HMOs and PPOs
Premiums and costs may vary
Limitednetwork possible
May require preauthorization or referrals to see a
specialist
May only cover emergency care
outside your service area
Medicare Part D – Prescription drug coverage
Separatemonthly premium
Prescriptiondrug coverage
Our Prescription Drug Coverage and MedicareOPM has determined that prescription drug coverage for FEHB plans, including GEHA is, on average, expected to pay out as much as the standard Medicare prescription drug coverage will pay for all plan participants and is considered Creditable Coverage. This means you do not need to enroll in Medicare Part D and pay extra for prescription drug coverage. If you decide to enroll in Medicare Part D later, you will not have to pay a penalty for late enrollment as long as you keep your FEHB coverage.
Review your plan options
Review FEHB plans before Medicare becomes primary
Lower premium plans may be adequate in the early stages of retirement
Plan changes allowed every year during Open Season
Becoming eligible for Medicare is a Qualifying Life Event (QLE)►Change allowed to
any option or any available plan
►Begins the 30th day before you become eligible for Medicare
►Only allowed once
1
2
3
Why should I pay Part B premiums?
Doesn’t my FEHB cover the same things?
Most FEHB Fee for Service (FFS)
Pay 100% of most medical expenses
Waive deductibles and coinsurance
Allow out-of-network, no referrals
Waive hospital pre-certification
Coverage overseas
Some plans offer Part B rebates
Lower premium plans may save you as much as plans offering Plan B rebates
Most FEHB HMOs
Network limitations may still apply
Reduce or waive copays and deductibles
Some FEHB HMOs offer separate
enhanced benefit plans specific to federal
employees.
Some offer private Medicare Advantage plans comparable to
FEHB HMO plans
FEHB coverage without Part B
Deductibles, copays and
coinsurance apply
Higherout-of-pocket
expenses
Consider health status
preceding age 65
Compare your plan’s catastrophic
limit to Part B premiums
Summary of Medicare and plan optionsMedicare and plan options Premiums you payA + B + FEHB Part B + FEHB
C + FEHB Part B + private insurance + FEHB(Some FEHB plans may not waive cost sharing)
C only (suspend FEHB)Part B + private insurance(premiums and coverage vary widely)
A + FEHB (no Part B) FEHB only
A + B + Tricare (Military retirees) Part B only
A + B + Medigap/Supplement + D (not for Feds)
Part B + private insurance + Part D premium
How GEHA works with Medicare Parts A&B
Medicare + GEHA – Compare plan benefitsWith Medicare A & B, GEHA’s Standard and High Option plans offer:
Covered inpatient and outpatient hospital services, surgeries and office visits,
at no cost to you.
Deductibles, copays and coinsurance waived
whether provider is in- or out-of-network.
Coverage when you’re out of the country,
where Medicare does not cover you.
High Option - up to $600 in reimbursements per calendar year.Use on Medicare Part B premium payments for High Option plan members
enrolled in Medicare Parts A & B.
geha.com/Medicare
GEHA Medicare resources
GEHA
dental
plans
Thank you!
This is a brief description of the features of GEHA’s medical plans. Before making a final decision, please read the plan’s Federal brochure available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.